冷热试验优势偏向与单侧反应减弱方向异同的临床意义

 目的  分析冷热试验优势偏向(directional preponderance,DP)与单侧反应减弱(unilateral weakness,UW)方向一致和相反时所代表的临床意义,探讨其对眩晕患者前庭功能评估的价值。方法  收集冷热试验中既有DP又有UW的眩晕患者125例,比较方向相反和一致时自发性眼震、感觉结构测试(sensory organization test,SOT)结果异常患者的比例,并行统计学分析。结果  125例患者中,DP和UW同向者35例(同向组),DP和UW反向者90例(反向组)。同向组中有自发性眼震者16例(45.71%),反向组有64例(71.11%),两组差异有统计学意义(χ2=7.05,P=0.008)。反向组中SOT提示前庭功能不足者的比率(74例,占82.22%)较同向组中高(24例,占68.57%),两组差异无统计学意义(χ2=2.77,P=0.096)。结论  DP和UW反向组与同向组相比,自发性眼震比率较高,提示两者反向时尚处于急性期;而两者同向时中枢代偿多已启动,但平衡功能仍较差,提示平衡功能可能比自发性眼震恢复晚。

The clinical value of the consistent or opposite directions of directionalpreponderance and unilateral weakness in caloric test

Objective  To analyze the clinical significance when the directions of directional preponderance (DP) and unilateral weakness (UW) are consistent or opposite in caloric test,and to explore the clinical value of DP and UW for the evaluation of vestibular function in patients with vertigo.Methods  We enrolled 125 patients with vertigo who had abnormal results of DP and UW in caloric test.The data of spontaneous nystagmus (SN) and sensory organization test (SOT) were analyzed and compared when the directions of DP and UW were consistent or opposite.Results  The patients were divided into two groups according to the directions of DP and UW (same direction group,35 cases;opposite direction group,90 cases) in the caloric test.Spontaneous nystagmus was obsereved in 16 cases in the same direction group (45.71%) and 64 in the opposite direction group (71.11%).There were significant difference between the two groups (χ2=7.05,P=0.008).The incidence rate of spontaneous nystagmus in opposite direction group was higher than that in same direction group.Balance disorder in vestibular system was founded in 24 cases (68.57%) in the same direction group and 74 cases (82.22%) in the opposite direction group in static and dynamic posture equilibrium testing (sensory organization test,SOT).There was no significant difference between the two groups (χ2=2.77,P=0.096).Conclusions  The incidence rates of spontaneous nystagmus in opposite direction group were higher than that in same direction group,which meant that different direction stage was still in the acute phase of vertigo,and same direction stage maybe had started-up the central compensation.Meanwhile,the recovery of balance function probably was later than that of spontaneous nystagmus.